TooTightPelvicFloor 2

If you’re interested in reading more on ideas presented in the article below, I suggest reading Move Your DNA: Restore Your Health Through Natural Movement – Expanded Edition. If you’d like movement instruction via video, start with Below the Belt for Men.

This morning my dad called, asking if he should be worried about his hypertonic pelvic floor (at 85-years old). Then he said he wasn’t sure where his pelvic floor was, but that it was probably down between his knees by now.

For those of you who don’t know, your pelvic floor is the muscular bottom of the bony pelvis

Photo from

which makes it much more likely to be between your hips than between your knees. If your pelvic floor is currently between your knees, turn off your computer immediately, find a camera, and email me the picture. I’ll be flying to your house today. (Do you like how everything is To Scale in this picture? What the…?)

I’m glad that my dad was alerted at the last email. It’s primarily women who tend to seek treatment for their PF issues because most know that they have one. A pelvis, I mean. Men, on the other hand, find the word pelvis to be similar to vagina in the fact that the both contain the letter “v”. Rest assured, gentlemen. You can have a pelvis and still be macho. In fact, the state of your manliness, if you catch my drift, depends on the state of your vagina-free pelvic floor.

Healthy functions (including sexual performance) is not only dependent on appropriate blood flow to the goods, but also the correct amount of tension in the surrounding muscles. Tighter is not better when it comes to pelvic function. Want better sex? Or hip health? Normal pressure in the gut? Read on, Mr. Mister, read on. That means you too, Dad.

The last post I did was about hypertonicity (too much tension) in the pelvic floor. So, where does hypertonicity come from? Here is a partial list of things that are shown to increase the tension in the pelvic floor:

Chronic stress

For a long time, tension patterns in the pelvic floor were linked to a history of sexual abuse and/or general abuse, but with further data collection, researchers have found that the vagina actually fires automatically in any sort of stressful situation. How’d they find that out, you ask? Seventy-seven women were lucky enough to be chosen to have their PF and their trapezius muscles (just to the right and left of the neck) hooked up to electrodes while watching all sorts of movie clips — some scary, some e-rot-ic, some a combination of the two, and some benign — people-running-through-flowers I guess. Turns out that pelvic floor tension is part of our regular defensive mechanisms. Long ago, the chances of you encountering fight-or-flight moments were few and far between. These days, being cut off by a Jetta-driving teenager who is texting and eating their lunch is enough to not only get your adrenaline surging, but your pelvic floor tensing as well. Who knew?

Physical trauma

Let’s face it. Some of us drive our cars better than we drive our bodies. The pelvic floor takes a beating for sure, and in response, it tightens to protect its precious cargo. From small loads, created by habitual straining due to constipation, to the repetitive pressures created by athletics (running and cycling are doozies), to the major blunt traumas of a one-time not-so-smooth vaginal delivery or sports injury — chances are you can find, in your history, an episode (or twenty) where you sent yourself into protective mode. And, you might have never come out of it. How would you, if you hadn’t known to?

Excessive tension in the core

Many movement and health professionals understand that the pelvic floor and the core fire together. And when it comes to biological functions like bathrooming and coughing and vomiting and laughing (ever done all 4 of these things at once? Good times!), it’s essential that the timing and force production of the core and PF are synced up.

When evaluating motor skills of the abdomen vs. pelvic floor strength, the pelvic floor often tests poorly. Why? Years spent trying to hold in our urine, or our farts, and living with modern stress loads while holding in our urine and farts, have messed up the natural timing (read: neurology) of this particular area.

When the pelvis reads as “weaker” than the core, once again, the logical solution seems to be to fix up the strength of that pelvic floor. Logical statements, however – while valid – are not always true. While it would make sense to bring the level of strength in the PF to match the strength in the trunk, what happens when the trunk is, like the pelvic floor, also too tight? In most cases of pelvic floor disorder, not only is the pelvic floor’s timing off due to chronic tension patterns, tension in the abdomen is also great. Great, as in too much — not great as in thumbs up.

But wait! If you had a lot of tension in your abdomen, you would have washboard abs, right? Nope. Tension in the abdomen has nothing to do with strength (Tattoo this in your mind: Tension does not equal strength). Chronic “sucking your stomach in” habits are found more often in those who feel they have something to hide, right? If you’ve got military posture, been slightly tucking your pelvis to give the appearance of a flatter stomach and butt, lifting your chest (at-ten-tion!), or have simply done one too many core exercise session, the tension in the diaphragm and psoas is higher than it should be. Read through these posts to measure the length of your psoas and evaluate your tucking-in-lieu of actual transverse abdominal contraction. And, another test:

Lie on your back, placing your hands on your lower abdomen. Cough and see if the lower abdomen bulges. Ideally, a cough should produce an upward motion, not a downward one.

If you find that you measure “positive” for all three assessments, time to relax the belly and release all those tense muscles!

Unhealthy surrounding tissues

Trigger points, points of extreme tenderness or weird “lumpiness” in the specific parts of the body are common in those with hypertonicity of the pelvic floor. Here’s a picture of some typical areas with excessive sensitivity to pressure and/or lumpiness:

Picture from Rehabilitation of the Short Pelvic Floor

What makes these areas lumpy and sensitive? No one knows how it gets this way, but muscles that are tight and non-innervated tend to pull on connective tissues (called fascia) in a way that gets the fascia all wadded up, so you’ve got this tight, cold (cuz there’s not much blood there), dehydrated, non-uniform muscle/fascia tissue bundled in chunks around your body. When you push on a big wad instead of smooth, supple layers, the pressure on the sensory organs becomes higher, which means you feel it more. I know, I know. Not pushing on it would seem like a good idea, except that those wads are telling you there’s a problem that needs to be fixed. Those areas are your body waving a red flag in your face. See me! Feel me! Touch me! Heal me! There’s a proverbial The Who concert happening in your pelvis right now. Make sure you’re showing up to listen!

How do you fix it? You’ll notice that the areas highlighted are those that you’ve seen in some of our Down There Rx..ercises. All starting to make sense now, ya? Gently working to bring awareness and use (and blood and release…) to the hamstrings, gluteus, adductors (muscles in the groin), piriformis, lateral hip, abdomen and deep hip rotators can instantly improve the state of the tissue. Also, a skilled somatic therapist/body worker can help you by gently working on these areas. Or, you can do it yourself! There are lots of great self-fascia aide kits like Yoga Tune Up® therapy balls that give you a step-by-step method to find those deaf, dumb and blind spots.

Sorry. Once I start down the path of metaphor, I can’t but help but extend it.

So what do we know so far?

In many bodies, pelvic floor muscles aren’t working because they are too tight, not simply too weak. Do a quick evaluation on your personal experience with chronic stress (for whatever reason), habitual physical habits, and tension in the gut. Do any of these relate to you? Give yourself a poke or two (go ahead, I’ll wait) and check out your body for soreness. Make a note of this data as well.

Restoring length to the pelvic floor is a combination of not only what you need to do, but also what you need to do less often.

Here’s my (read: your) to-do list:

1. Become aware of the state of the tissues in related areas (i.e. abdomen, hips, glutes, SI joint, hamstrings.) Are they sore? Stiff? Tight? Work on these via touch and gentle corrective movement.

2. Sit better. Watch this “how to sit” video to make sure you’re not overloading your sacrum all day by sitting on it.

And, to use different muscles and joint configurations, check out this post for various sitting postures that are more beneficial that the blasted chair-couch-car seat you sit on all day! (click)

3. Sit less. Frankly, no matter how you sit, it’s likely too much. (Take the “How Much Do You Sit Quiz HERE!) Lots of regular walking throughout the day (with a posterior push off) keeps the pelvic floor in balance naturally. A few exercises can’t fix the lack of use stemming from all-day, 9-5 sitting. Figure out how to take walking breaks every hour, even if it’s just for a minute or two. Walk first thing in the morning, again at mid-day and once before you go to bed. This has been shown to aid in increasing circulation to the pelvic floor.

4. Start using a squat toilet. You don’t even have to use muscle strength. Just popping your feet up a little higher than usual will help open the joints and muscles of the hips and pelvis, making elimination easier. If you’re straining at all while using the toilet, then I can’t recommend this enough. You don’t even need to buy anything at first. Just haul a couple of boxes or turn a waste-paper basket over to put your feet up.

5. Meditate. I know you know this can help you, but for some reason it’s the last thing people can make time for. Seriously. If you’re dealing with hypertonus of, well, anything really, it means that your mind is tense. You can’t fix your body without addressing the mind. Sorry. I’ve tried it and it just doesn’t work. No, you don’t need to take a course in meditation, buy a special pillow, or stop eating meat and drinking beer. How about just lying on the floor, setting your phone alarm for 10 minutes. Lie there. Do nothing, including sleep. It’s not about resting, but about taking 10 minutes to actually feel the state of your body. When things hurt at night, they’re typically hurting you all day long, you’re just really good at distracting your mind from the pain. Take 10 minutes to listen to what your body is telling you. Are your habits working for you, yes or no?

6. Reduce exposure to scary stuff. While your mind might be aware of the difference between real and fiction, your body, evidence shows, does not. I treat my eyes and ears in the same way as I treat my one-year old’s. If he can’t watch it, then I don’t either. You know that filtering your food and air are important. Put those same parameters on movies, music, words, and relationships. If something’s toxic, it’s toxic — and your body will react in a way that protects you in the moment while leading to long-term damage.

7. Check for other tight muscles. (psoas, sucking, quads, neck/shoulders)

Tight muscles love company. Well, not really, but they tend to come in clumps. You’ve evaluated your psoas, right? Check your gut and let that go. Same goes for your neck, jaw, and knee caps! Watch the video on this post (click) to see if you’re quads are also jammed up!

8. Evaluate diet.

If you’re bearing down a lot or have dealt with chronic constipation, make sure you’re getting plenty of water, fiber and fat! If those are all good, then that chronic constipation is likely stemming from your body’s tension. I’m going to suggest some abdominal massage here: Look into abdominal massage! But, I’m going to be writing more about this, so check back for more info beyond recommending it 🙂

9. Align the pelvis. Ah, perhaps the foundational piece! The joints of your hips, knees, and spine can alert you to the lengths of the muscles that attach to the pelvis. And you can’t fix the pelvis until you stop pulling it away from where it works best! Read through this blog and learn more about the pelvis, where it should be, etc. Also, consider the pelvic floor video (coming soon as a phone app. Word!) Down There for Women. And, there’s one for the fellas too: Below the Belt for Men. (Please note, the exercises are the same on both titles. However, our research showed that no matter how much they loved their wives, men were not down with watching their vagina-y exercise DVD. Women, on the other hand, don’t care. Interesting…)

10. Get some glutes. Seriously. Put “Butt for Christmas” on next year’s list. This one can really help you out!

11. Reduce physical and psychological stress. This one is tough if you’ve been using high impact or high intensity exercise to deal with stress. You’re going to have to pull it back a notch while working on correcting the pelvis. Find one or two things you can do to reduce your daily stress. Leave the iPhone at home every now and then. Take a walk. Listen to quiet music. Bring ear plugs to work. There are so many ways you can reduce your stress, please don’t write this one off with a “there’s no way I can do anything about my life” attitude. Your health depends on you doing something about it.

Wow. This post ended up super-long as well! Time for me to take my pelvic floor for a little stroll.

Peace, love, and psoas.



From Chronic Pelvic Pain and Myofascial Trigger Points. The Pain Clinic, December 2000, Vol.2. No. 6:13-18.

To visualize how the pelvic floor responds to stress, one need only look at the movement of a dog’s tail: when the dog is happy, the tail wags loosely from side to side; when the dog is stressed, the tail is tightly under its legs. It is the pelvic floor muscles that control the tail. In fact, the pelvic floor muscles are still attached to the rudimentary tail [in man], the coccyx, which is pulled forward when contracted, thereby compressing its penetrating organs. Therefore, man’s pelvic muscles, as the dog’s, may be the ultimate representation of the mind/body connection, for they are constantly responding to fluctuations in feeling.” – Jerome Weiss, MD

So many articles went into writing this, but here’s a few if you’re interested in reading more!

Bø K. Urinary Incontinence, Pelvic Floor Dysfunction, Exercise and Sport

Sports Medicine, Volume 34, Number 7, 2004 , pp. 451-464(14)

J. van der Velde, W. Everaerd. The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behaviour Research and Therapy Volume 39, Issue 4, April 2001, Pages 395–408

J. van der Velde, E. Laan and W. Everaerd. Vaginismus, A Component of a General Defensive Reaction. An Investigation of Pelvic Floor Muscle Activity during Exposure to Emotion-Inducing Film Excerpts in Women with and without Vaginismus. Volume 12, Number 5 (2001), 328-331.

Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor. M.P. FitzGerald and R. Kotarinos. International Urogynecology Journal.Volume 14, Number 4 (2003), 269-275.

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51 thoughts on “TooTightPelvicFloor 2

  1. Hey Katy,

    I’ve been looking for an opening to ask you about cycling, that is, bicycling. I’ve searched your blog for references to biking, but you’ve mentioned it in this post, so…

    There’s no question that both recumbent and upright bikes foster poor alignment habits, but driving a car fosters poor Earth care habits. Yes, walking is cool too, but bikes allow one to go soooo much farther in a day. Given that using bicycles for transportation, compared with cars, is WAY green and way cheap, I would love to see a post about how to minimize the damage a bicycle can do to one’s body.

    Thanks for your thoughts!

    1. I know, sounds like a good post idea, right? I’ve been working on one, but here’s the thing. The damage to the pelvic floor, discs in the spine, psoas, internal pressures and bone density come from the seat, the repetitive hip flexion (read: pedaling), and the handle bar height. In order to not have body damage, you’d have to stand up off of your seat, retrofit your bike replacing the circular motion of the pedals for some sort of propulsion mechanism that mimicked cross country skiing, and bring your handle bars up and towards you until your spine could remain in neutral. Which, at that point, would mean you were essentially walking. So far the *best* way I’ve found to use your bike for long term mobility is walking next to it as you push it around. And that can really slow you down. You know what’s even cheaper and greener than a bike? Using those legs and pelvic floors a couple hours a day! If we could only de-stress our lives a bit (and HEY, that’s a step in reducing chronic disease as well!) and find a little room to change our mindset, we could have Whole Body Health! Isn’t that great!!!??? I know. I’m an idealist…

      1. I am a man who has been suffering with this horrible condition for 2 years now. The pain was excruciatingly painful. It was at least a 9 out of 10 for 1.5 years. I almost lost my job over it. My wife and son have since left me because of it (going on about 9 months now)and the fact that I tried to take my own life because I couldn’t handle the pain and the fact that no doctors or physiotherapists were able to help me. Some family and friends thought it was all in my head. Since it is a condition of exclusion, a lot of people think it is all in your head.I saw multiple specialists with multiple tests before receiving the diagnosis of pelvic pain tension myalgia. I went to a physiotherapist for 8 weeks to no avail. She didn’t do any internal or external trigger work or external massage work. All she did was have me do stretches, kegels, and the tens machine. She seemed at a loss on how to treat a man with pelvic issues. I have extremely tight pelvic muscles per her findings. In addition, I also had extreme constipation, urinating every 10 minutes, incomplete evacuation, short term ibs, and couldn’t sleep because of the constant nightly urination. Well I started walking and resting a lot and one day my symptoms all went away, about 4 months ago. I thought I was home free. Now, I have pain that is a 5 out of 10 and getting small defecation issues back again. I made an appointment with my urologist to get back into physio work again. It hurts a lot when I sit for a while on my left groin, abdomen and left testicle area. I’m trying to stay positive and taking Lexapro and Ambien at night, but this is very frustrating and discouraging. I bought ” A Headache in the Pelvis” and a theracane to try. I am doing stretches out of the book every night. I don’t know what else to do, but there needs to be more support groups and more awareness for men with this problem.It really can destroy lives. It destroyed part of mine already and now it is back again. Does insurance cover a second round of PT?

        1. After you completed your walking/rest treatment, did you stick with that, or did them symptoms return after you went back to more usual habits? (Trying to gather if they came back as you kept walking and resting.)

          1. Katy,

            I’ll be honest. This is embarrassing to talk about but I’m sure probably pertains to my case and worthy of mentioning now that I think of it. I had been away from my wife for about 8 months when I decided to relieve some sexual tension by pleasuring myself. It was probably the next day or a few days after when the pain returned again. In addition, I did fall off my normal routine once I came back to work and didn’t walk as much as I did when everything seemed to return to normal. I was also incredibly stressed out from everything going on in my personal life so was probably holding a lot of tension from that too. I was going to use the theracane and try some of the external trigger points listed in “A Headache in the Pelvis” too, but got a little scared I was going to make things worse. My urinary and defecation symptoms are not as big of a problem this time around and no ibs symptoms yet, but the pain and the burning in my lower left abdomen, left groin, and left testicle are back again. Once again, not as severe as it was before I thought I was healed, but still about a 5 out of 10. It seems when I lay on my back and walk, most of the pain goes away in that moment; then it returns again after I sit down or try to lift anything with any weight to it at all. I try to stand every 20 minutes at work and pace around the office as much as I can. The pain seems to almost go away on some days, like a 2 out of 10; then on other days, for no reason other than sitting at work maybe, comes back at a 5 out of 10. There seems to be no rhyme or reason to the severity of the pain. Sometimes I do the stretches I was taught by my previous physiotherapist and it feels like it is helping and sometimes I do those same stretches and I’m in pain the next day.

          2. I also have similar symptoms. I just turned 31, used to workout every morning and go to the desk job afterwards, but the tight PF has been ruining my life for the past 2 years… I cannot defecate or urinate completely, and I had to limit my food intake as a result, so now I am getting weaker with this limited baby food diet full of low residue vegan stuff….. I used to be able to walk barefoot and stand for longer periods, now I cannot walk far, sit too long, or stand, even when using worthless orthotics. Low drop shoes feel better, but I still need arch support due to pronation issues….. My PT has recommended to limit/stop exercising (although I can barely life anything at the gym now and can’t do the elliptical more than 10 minutes), but I feel my glutes need to be stronger in order to hold me up so I can sit, stand, and walk… Some of the necessities in life….

            Based on these symptoms, here’s my questions:

            1. Is there a transition shoe to help me walk barefoot eventually that provides support (I use vivobarefoot dress shoes with some orthotics and crossfit shoes with inserts)?
            2. What is an effective way to strengthen the glutes without aggravating the obturator internus muscle (triggers PF pain)?
            3. Sitting makes EVERYTHING WORSE in the PF, but it is my only resort when my hips give out from standing/walking too long… Should I just sit whenever I feel hip pain?
            4. Is the psoas release (laying on the bolster) the best way to release the psoas when I am “hypermobile”? I tried the kneeling stretch but never much, either does the laying theracane work….
            5. Are there any “safe” core exercises to work on since my rectus abdominis is dominant and making my TVA weaker, which is causing pelvic and back pain?

            I would greatly appreciate your response.

  2. Great post Katy. number 6 is something I’ve never thought about before, but makes total sense obviously. sometimes having a baby around makes you healthier! I don’t eat as much junk as I used to since I had a kidlet, and I certainly don’t watch as many movies, and the type of movies I watch are much more friendly to the system. Very feel good, very smile inducing. Pride and Prejudice with Keira Knightley is my favorite one. The music is so soothing. Marie Antoinette is a close second, cause the color pallette makes my eyes feel good. 🙂 Anywhoot, very interesting read. I love learning new things every day!

  3. Nothing substantive to add but had to share that the thumbnail image that pops up when you try to Facebook this is the wildly out of scale penis one.

    That’ll drive some traffic, no?

  4. Great post! Do you have any specific recommendations, sleeping positions, etc. for bladder pressure, especially at night? Your comment about the distractions during the day ring so true regarding the ability to “ignore” tension and discomfort. Once the day quiets down, though, wow….all is revealed!

    I have just received your “Down There” for women DVD yesterday and started the excersices with hopes of some releif soon! Any other specific “bladder issue” suggestions would be appreciated. Thanks!

  5. Katy, as someone who has PFD, I have been reading your blog like crazy and doing your ‘down there’ video for the past two months. You’re awesome and I appreciate all that you do!

    You frequently mention building up glute strength, but don’t always say how. I mean, I know walking and squatting, but is there anything else to do?

    Also, do you believe that lifting weights to build muscle strength is bad? In case it matters, I’m talking about 10-15 lb. weights, not weight machines. Obviously, it depends on the type of exercises, but initial thoughts?


    1. Hi! Thanks for reading. My initial thoughts are, just like the PF is tightening in response to a ton of unnatural behavior, you want to be careful not to create the same issue in the glutes. Building arbitrary strength in the glutes can hinder progress if not done correctly. The glutes natural function is to extend the hip while walking, to keep the femur “neutral” in the hip joint, and to stabilize the sacrum (relative to the thigh) while walking. Once your walking includes hip extension (which is entirely limited by a tight psoas which I believe you have after reading your other comments) and pelvic listing (read some of the walking mechanics posts too!), and aiding in coming up out of a squat. That’s really enough strength and in a direction (muscularly) that benefits the pelvic floor. I’m not sure how you can fake these motions in an exercise session if your body can’t actually do them yet, if that makes sense! It’s not so much that the glutes are weak due to neglect (although all that sitting…) but that the tension patterns in other muscles are impeding on their function. That’s why I don’t focus too much on the strength part — that will come once time and attention have been given to ceasing more detrimental muscular tensions…hope this helps!

  6. Also, Katy, while I am asking questions. When I stretch my hamstrings using a belt, I have a ton of space between my leg and the floor. In your Down There video you say this is bad, but no matter how I tilt my pelvis, I still have lots of room–like I can easily put my hand under there with room to spare. The best I can explain is that it feels as if my butt is so round that I have extra space there. Obviously my hamstrings are super tight, but what can I do to get to the point that my leg is flat on the floor?


    1. Did you evaluate your psoas, using the bolster. While doing the hamstring stretch, if your other leg doesn’t touch, then you need to prop your torso up until your hams make floor-contact. It’s not your butt, I promise 🙂 Once you see the angle between your upper body and legs, you’ll have a better appreciation for how much your psoas is folding you in half, essentially!!!

  7. Hi Katy- so, hip extension is limited by a tight psoas and the function of the glut is to extend the hip. Does this mean that you must first have a supple psoas for the gluts to do their job with extension? Cause if the Psoas is not at correct length, gluts can’t fire?? I loved this post!! Thank you!!

  8. Hi,

    Thanks, when testing if the stomach bulges do you mean bulging anterior or superior?

  9. Thank you for talking about the weird “lumpiness” on the lower back. I hurt my back while pregnant and nothing in my body has been the same since. I have grinding pain in my hip, knees ache at night, always lower back pain that occasionally causes sciatic shooting pain that sends me to the floor. When I finally was convinced to go to chiro. I asked her about all of this and she said I am a baby carrier that slumps while sitting and basically there is no hope for me. She also said that that she has no idea why those “lumps’ are there. I thought that was odd since she said she sees it many times in chronic back pain patients but never bothered to find out why. I am so thankful for your patient explanations.

  10. Thanks for the shout-out Katy….Deaf, Dumb and BLIND Spots…you know I’ll be using that in my next Yoga Tune Up class! I love the “dude” emphasis. BRAVO! This blog is so extra stuffed with goodies, you have given such a gift! Looking forward to Part 3!

  11. Thank you for this info! 10 years ago I was diagnosed with Hypertonic Pelvic floor, and since then have had chronic urine retention. The urologist just told me I had to use a catheter to empty completely, and I have been looking for a natural solution for all this time. I didn’t know if it was my C-section that did it, or falling down the stairs and landing on my tailbone. Thank you, thank you, thank you!

  12. Hey, K-Bow, you is so inspiring!! This blog is simply fab, dahlink!! Lookin’ for more on that abdominal massage…the Mayan version was presented, though not too well, at Trust Birth. I am waiting for the next installment…..btw, my 12 year old daughter is learning this right along with me…we are officially “Big Butt Groupies”! ROFL!!

  13. Hello Katy! I’ve recently discovered your blog. Now I’ve got the “You Don’t Know Squat” exercises printed out and my rolled up yoga mat waiting for me when I get home.

    I have a question. I’ve got a standing desk at work and since I’ve started doing your stretches I’ve noticed that I stand with my glutes clenched. When I notice I release them and my back seems to return to a nice curve. Am I sensing this right?

  14. Hi Katy,

    Is it possible to have a too-tight pelvic floor after a vaginal birth?

    My baby is now 3, and I am 5 months pregnant. I didn’t manage to recover my pelvic floor in the meantime. Perhaps I had a too-tight pelvic floor before the birth (I had never before worried about PF, since I never felt any discomfort at that level, whatever the amount of strain I was engaging in), I really don’t know. But since baby, it all feels too loose, and I’m having some prolapse symptoms, so I would like to understand the cause. As my pregnancy progresses, I am feeling increasingly sore in the areas marked on the picture, even without touching. Is it possible to have a too-tight and too-loose PF simultaneously??


    1. You can’t have a tight and loose one, but a tight and weak one, sure… Also, the areas indicated on the blog would also be sore to the touch if those muscles (glutes, lateral hip, etc.) weren’t functioning regularly. Check out the monster walk, the pelvic list, get a butt and the crotch bones exercises for more info on what to do!

  15. I’m not sure this is the best post to place this question. But assuming that the same principle of that too short muscle cannot develop properly would apply to other muscles as well, should the training of the hips and glutes also be accompanied by stretching exercises? I am wondering in particular if I could possibly have short lateral hip muscles, and what I should do in that case. Thanks for any tip!

    1. Yes! Read up on many posts here — you’ll find the answers you are looking for re: supporting muscles, etc. Definitely a stretch/strength ExRx is in your future!

  16. Howo you know if your pelvic floor is tight? I feel like I am “straining out” or bearing down, when just lying down. I can reduce the outward pressure by Doing a kegel, but that is obviously not sustainable. I know I need to work on my buttmuscles and I have diastasis recti. Thanks, I am reading your articles voraciously, a whole new world.

    1. If you feel like you’re bearing down, it sounds like you’re pretty in tune with the tension! Also, the DR is often found in conjunction with the TTPFloor. Work on relaxing. Then the butt. Then the trunk — or all of them, slowly. Good luck and thanks for reading!

  17. Also, this is a bit off-topic, but I use a standing desk and am ow 12 weeks pregnant. Keep being told to sit to avoid varicose veins. Should I be sitting more or just paying attention to my alignment?

    1. No need to sit more, but definitely move, adjust, wiggle, etc — even calf stretch! while standing because standing is just better than sitting. Still not better than moving. 🙂

  18. Thanks, Katy. You rock. Am definitely going to order the “Down There” DVD and the “No More Kegels” course. So excited to have found your blog and to be given the tools to better understand my body and control my health outcomes.

    One more question -am going to see a physio soon who specializes in women’s health issues about my distasis recti. Talke to her today on the phone ( haven’t been seen yet) and she said they typically do not recommend working on repairing diastasis recti while pregnant (I am 12 weeks prego). I am already showing (third pregnancy) and already feel pressure that I associate with the DR. I do not want to wait until post-partum to do something about it. Am I correct that your advice on DR is that it is caused by poor alignment and that if that is corrected and the butt is built up, then the DR will be better managed? Is there anything else I can do?

    Thanks again for your Facebook site, your blog and your DVDs and courses.

    1. You are correct in that DR is created by how you load your skeleton. I would imagine that from a PT perspective, getting you to do a bunch of core work (typical DR protocol) would not be right during your pregnancy. Dealing with the root cause of DR, however, that is not letting this pregnancy exacerbate something that is already there, working on correcting your internal pressures and joint loading is absolutely something you can and should be doing now. CONGRATULATIONS on being 12 weeks prego. IMO there is no better time to start. You can do the courses/DVD exercises now and should have no problem modifying everything necessary! Also, read through all of the prego blogs. I’m prego too, so there are a lot of them 🙂 Thanks for your email and HAVE FUN learning about your body!

  19. Thank you, thank you, thank you. Thanks to you, I am having fun with this rather than being discouraged by conflicting information, which is so great. And congrats to you too!

    🙂 🙂 🙂

  20. Hi Katy,

    great post , I have been devouring your posts on the pelvic floor especially those relating to male pelvic floor issues.

    I am enjoying your dvd on below the belt for -> Men , to try and relax my extra flighty pelvic muscles. My question is regarding how anterior pelvic tilt would effect the pelvic floor?

    at the moment when I look at myself relaxed in the mirror I am very anterior tilted and often get lower back pain especially when standing up or walking. I find I do sit on a tucked pelvis which makes my back feel better but it has given me the inability to relax my pelvic floor muscles, and from reading your posts I know sitting on a tucked pelvis is a big no no

    it feels like a battle between an anterior tilt Vs. a relaxed pelvic floor. Can you recommend any online courses or dvd’s to help me out . Thanks

    1. Ant. pelvic tilt affects PF tension in the same way as a post tile — it limits hip extension while walking, which means that the glute doesn’t fire regularly enough to balance the chronic load placed on the PF. You need to release your psoas, illiacus, and quads — especially the illiacus and quads, because they keep you in hip flexion. The online PSOAS course is good — you might also want to check out the psoas, pelvic floor, and quads and hams Alignment Snacks. They are $5 bucks each, so a good place to start. Good luck!

  21. Hi, just discovered your website. Have spent thousands on physio, chiro, and PF PT. Looking to find healing within from now on. My pain started about 4.5 years ago with running where I felt a sharp pain behind the knee – the pain DID not originate in the PF. It then slowly but completely radiated and consumed my legs. I have trouble sitting, walking, and standing. However, I began to notice pelvic tilt which grew more and more noticeable. I definitely have symptoms of PF dysfunction, definitely. The problem is that much of the exercise that’s recommended, aka movement starting with walking, is too painful. I have never read anything that discusses leg pain (including cramping throughout, especially toes, numbness through feet, etc.) related to PF dysfunction.

    Any thoughts and what to do about not being able to incorporate walking pain free into your suggestions above?

    Many thanks,
    Otherwise healthy 32-yo w/ no kids

  22. {
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  23. Hey Katy

    Been reading your book Allignment Matters recently and have been really enjoying it. Im a Yoga teacher looking to always further my knowledge especially with allignment. I am very curious about ‘tucking the tail’ in the Yoga Asanas, especially with the back bends. I’ve learnt to tuck my tail and also instruct it in order to protect the lower back. In your book however you talk about not tucking the tail, which I get on an every day basis but when it comes to Yoga and temporarily tucking the tail in the class what are your thoughts? For example poses like: Bridge, Lower lunge, camel pose i feel that tucking in the tail helps but obviously its the degree to which you do it. Like If i tuck my tail i am able togo deeper in to the back bend. Theres also a difference between tucking the tail and the pelvis so maybe there is also confusion with that in yoga. Maybe you have written about this somewhere in the book as I havent quite finished it and would love to get your thoughts. Thanks a lot

  24. Hi Katy,

    I feel my TVA contracts when I avoid butt gripping, like a an involuntary tightness in the lower belly. Looks like a good thing since that feeling is new, so i never really used that muscle before. I used to think butt squeezing and straight back was part of having a strong core (think plank), and that letting the butt stick out was a bad habit that would lead to low back problems and anterior pelvic tilt. I also have the bad habit to thrust my ribs to stabilize. So i got a few things in reverse!

    Is it normal though to feel that I get tense pelvic floor discomfort along that lower belly tightness when my TVA contracts standing up? Is there a transition period where both TVA contracts while PF remains too tight. I mean, if synergistic imbalance of the core is the problem, my guess is pelvic floor will continue to trigger hard at first, but will slowly let TVA do most of the work eventually so my PF relax. I have this reflex to butt clinch to give this sensation/pain some relief. I tuck in a lot when sitting too, which gives me relief even though I know I shouldn’t. Am i doing something wrong? Will this stop once my TVA gets stronger?


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